Management of Limited Interocclusal Distance with the Aid of a Modified Surgical Guide: A Clinical Report

Background and Objective: In completely edentulous patients, limited interarch distance can compromise conventional prosthetic fabrication. Bone reduction through various surgical procedures has been recommended to restore an acceptable interarch distance. In such circumstances, a surgical guide built on a mounted cast can be used to minimize and control the amount of bone reduction performed. This clinical report describes an innovative method for development of a specific template to guide precise amount of surgical bone reduction performed in an edentulous patient with limited interarch space.Patient Report: A 36-year old female completely edentulous for less than a year and seeking a complete denture was presented to the Department of Prosthodontics. The maxillary tuberosity was very close to the mandible in the rest position. A panoramic radiograph revealed maxillary ridge and tuberosity prominences with pneumatized sinuses. Although implant supported prosthesis was offered as a treatment option, it was not accepted by the patient due to financial burden. Intraoral examination showed that the mucosal membrane was normal in terms of color, consistency and attachment to the underlying bone. The ridge had a hard bony consistency upon palpation, with no sign of displaceable or fibrous tissue. However, the entire maxillary residual ridge showed enlargement with severe prominences in the posterior region.Conclusion: As a result of alveoloplasty, she had gained 10mm interarch distance; thus, her treatment was completed with satisfaction following conventional procedures for edentulous patients.